Endocrine Abstracts

Objective: The aim of the study is to describe the prevalence of hyperlactatemia and changes in lactate concentrations in critically ill patients, and the associated mortality.

Materials and methods: The study included 70 patients treated in the Medical Intensive Care Unit at the Clinical Center, University of Sarajevo, in a 6–month period. The following data were obtained: age, gender, reason for admission, Simplified Acute Physiology Score II, Acute Physiology and Chronic Health Evaluation, lactate concentrations upon admission, after 24 and 48 hours, and outcome.

Results: Hyperlactatemia upon admission was present in 91.4% patients with mean lactate concentrations of 4.13 ± 1.21 mmol/l. Lactate concentration at 48 hours was independently associated with increased in–hospital mortality (P = 0.018). Lactate concentration after 48 h represents a statistically significant predictive marker of fatal outcome in patients (AUC 0.874, CI 0.769–0.980 P = 0.001) with a cut off value of 2.25 mmol/l, and sensitivity of 72.2% and specificity of 92.1 %.

Conclusion: Persistent hyperlactatemia is associated with adverse outcome in critically ill patients. Lactate concentration at 48 hours is independently associated with increased in-hospital mortality and it represents a statistically significant predictive marker of fatal outcomes of patients. Blood lactate concentrations > 2.25 mmol/l can be used by clinicians to identify patients at higher risk of death.

Keywords: hyperlactatemia, critical illness.